Ask the Fight Doc: Should Mark Hominick's hematoma have prompted a stoppage?

It was one of the more grotesque images coming out of this past weekend’s UFC 129 event, but was it dangerous?

When title challenger Mark Hominick fell short to featherweight champion Jose Aldo in a spirited UFC 129 co-headliner, the Canadian’s forehead ballooned up to epic proportions with a noticeable hematoma.

In our latest “Ask the Fight Doc” installment, MMAjunkie.com medical columnist Dr. Johnny Benjamin discusses the nature of hematomas, whether officials made the right call to let the fight continue, and how such injuries are treated.

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With the massive swelling on Mark Hominick’s forehead, should his UFC 129 “Fight of the Night” with Jose Aldo have been stopped?

As soon as I saw the enormous and rapidly expanding “alien” erupting from the forehead of Mark Hominick, I knew that my inbox would be overflowing.

In a sport as action packed and violent as MMA, there are several topics that are extremely difficult for passionate fans to navigate logically: weight-cutting, performance-enhancing drugs, flash KOs, retirement due to accumulation of trauma, and doctor stoppages, just to name a few.

I often must harness my inner fan and limit my comments to those hot-button issues that are medically related within my field of expertise.

Once again, as I have stated many times, there is a significant medical difference between injuries that are visually compelling (and even grotesque) as opposed to those that may be life, limb, neurologically (paralysis) or sensory (vision, hearing etc.) threatening.

Visually compelling injuries (many cuts/lacerations, abrasions, contusions, hematomas/bruises etc.) need to be properly inspected by properly trained and seasoned cageside medical staff, observed by vigilant referees, and managed by well-trained, experienced corner men. These injuries can provide amazing theater and crowd reaction, but when properly handled, they pose minimal risk to the affected athlete. These types of injuries are minor and do not put the fighter at a significant increased risk.

In these instances, the fight should continue.

An enlarging forehead hematoma (bruise or collection of blood) that does not significantly affect an athlete’s vision is not dangerous. The ring side physician made the proper call on a huge stage. Job well done, sir!

FYI: Post-fight after a thorough cleansing to decrease the chance of infection, a large-diameter needle (since blood is thick) will easily evacuate the collected blood. Ice and a pressure dressing are then applied to retard the re-accumulation of blood. This minor procedure should happen without delay before the blood clots and before the blood is more difficult to remove and becomes possibly disfiguring (think cauliflower ear). Channeling Rocky and “just cut me Mick” between rounds is not an option.

On more than a few occasions, I have been critical of promotions, state athletic commissions, referees, medical personnel and even fighters for their medical decision-making processes that seemed to be flawed. (Yeah, I didn’t win a lot of friends with those articles and interviews.) And, I’ve also sung the praises of those that get it right even when their decisions were almost certain to be viewed as very unpopular. (And those pieces got me labeled a suck-up or far worse.)

In my opinion, the UFC and most MMA far exceed other major sporting leagues (NFL, MLB, NBA, NHL and professional boxing) when it comes to athletes’ safety during competition.

Unlike professional boxing, the cut men are consistent, all superbly skilled, experienced and supplied by the UFC. They are not the fighters’ cousins or uncles like we commonly see in boxing. If a fighter gets injured, he can rest assured that he will receive exceptional care between rounds – every time.

The referees are experienced, exceptional and consistent. (Welcome back “Big” John McCarthy.)

If we could just do something with some of the judges (did I say that?).

In the UFC unlike the NFL, NHL and MLB, physicians (team doctors) who evaluate the athletes are not paid consultants of the team and viewed by the athletes as having a potential conflict of interest.

Now, if the UFC would just institute Olympic-style year-round drug testing…

For complete coverage of UFC 129, stay tuned to the UFC Events section of MMAjunkie.com.

Dr. Johnny Benjamin is MMAjunkie.com’s medical columnist and consultant and a noted combat-sports specialist. He is also a member of the Association of Boxing Commissions’ MMA Medical Subcommittee. Dr. Benjamin writes an “Ask the Doc” column every two weeks for MMAjunkie.com. To submit a question for a future column, email him at askthedoc [AT] mmajunkie.com, or share your questions and thoughts in the comments section below. You can find Dr. Benjamin online at www.drjohnnybenjamin.com, and you can read his other sports-related articles at blog.drjohnnybenjamin.com.

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